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Host Defenses and Infectious Complications in Maintenance Hemodialysis Patients

  • Ann Rinehart
  • Allan J. Collins
  • William F. Keane

Abstract

Prior to the advent of chronic hemodialysis, infection was a frequent terminal or pre-terminal event in patients with end-stage renal disease (ESRD). During the 1960s–1970s chronic hemodialysis therapy infectious complications resulted in significant morbidity and mortality, with up to one-third of deaths being attributable to infections (1, 2, 3, 4, 5). Despite improvement in dialysis and medical therapies, infection continues to account for a significant proportion (11 to 36%) of deaths in the chronic dialysis population (6, 7, 8, 9, 10, 11, 12, 13, 14). While this increased risk of infection is due to, in part, the necessity of blood access and/or complications of their underlying disease, there are abnormalities of the immune system in ESRD patients which may contribute to their predilection for infectious complications. In this chapter, we will review the incidence and types of infectious complications which occur in patients undergoing chronic hemodialysis, as well as outline our current understanding of the immune status of the dialysis patient. Quite importantly, the vast majority of infections are due to commonly occurring organisms, not opportunistic or unusual organisms, and repetitive exposure to infectious risk factors impacts on the types of infections observed

Keywords

Peritoneal Dialysis Chronic Renal Failure Dialysis Patient Hemodialysis Patient Iron Overload 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Ann Rinehart
    • 1
  • Allan J. Collins
    • 2
  • William F. Keane
    • 3
  1. 1.Department of Medicine/Div. of NeprohologyHennepin County Medical CenterMinneapolisUSA
  2. 2.Regional Kidney Disease ProgramMinneapolisUSA
  3. 3.Division of Nephrology Department of Medicine Hennepin County Medical CenterUniversity of MinnesotaMinneapolisUSA

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